Louisiana Gov. John Bel Edwards COVID-19 Press Conference Transcript August 13

Gov. Edwards: (00:00) ... to cover our response to this pandemic, we're joined again today by Dr. Joe Kanter of the Department of Health. Want to thank him for his hard work throughout this pandemic. Also joining us today is Dr. Amanda Logue who's the Chief Medical Officer at Ochsner Lafayette General. And we also have Dr. Terry Thomas, who is an OBGYN and the chair elect of the board of directors at Woman's Hospital here in Baton Rouge. And they'll all speak to you in just a moment. And I'll start by saying we don't have much good news today. As bad as things have been over the last couple of weeks, they've just continued to move in the wrong direction. And there's nothing in the data today that suggests that we are at, or nearing the peak of this surge, which is very, very concerning. Having said that, however, I would like to start off on a positive note and I want to talk about some winners of the Shot At A Million campaign as we wrap up this campaign. Gov. Edwards: (01:17) I had the tremendous privilege yesterday of speaking to the five recipients of the last $100,000 scholarships, and they are Emily Guillet, 13 year old from right here in Baton Rouge. Emma Fisackerly 16 year old young lady from New Orleans. Gavin Harrington, a 13 year old from Rosedale. Jackson Page, who is 17 and from New Orleans. And he starts his higher-education next week at Georgetown University. And so this was obviously a great turn of events for each of these five young people, but for him in particular, I suspect. And then finally we have MacKenzie Rigdon. She is 15 years old. She's from Metairie. She is one of five children, all of whom are nearing college age. And I promise you, her mother was more excited than she was about the $100,000 scholarship. So I want to thank each of them again for making the decision to be vaccinated, for making the decision to then register. And then I congratulate them on their winning. And I know that all of them are going to go on to higher education and I'm excited for them and their future. Gov. Edwards: (02:47) And then now it's my honor to announce that the recipient of our $1 million grand prize, cash prize is Janet Mann of Bossier City. When they told me Janet had won, I knew a little bit about her and I was already excited. But when I found out that she's a retired elementary teacher and she taught special ed in both Bossier Parish and in Caddo Parish over the course of her career, I was extremely happy for her. And she is deserving of this. I too want to thank her for making the decision early on to be vaccinated. And Janet, if you will come up, I am going to present you with this check. And because it's not drawn on my account, I expect that the bank will honor it. [inaudible 00:04:11] Gov. Edwards: (04:18) Thank you, Janet. And congratulations to you on all of our Shot At A Million campaign winners. Obviously, the point of the campaign was to encourage people to get the COVID-19 vaccine and to get it as soon as possible without waiting. And obviously when we announced the campaign, we weren't in this current surge. It's actually more important than ever that people get vaccinated. But there's more news on the incentive front with respect to vaccines. Today, I'm announcing a brand new vaccine reward program, it will be Shot For 100, where we're going to give $100 to the first 75,000 college students who get vaccinated at participating institutions of higher education. This is incredibly important as school resumes because 18 to 29 year olds, and you're going to see this with Dr. Kanter in just a few minutes, and you've seen it before over the previous weeks, a huge percentage of our cases and transmission are being driven by people in this age group. Gov. Edwards: (05:31) And quite frankly, it's one of the lowest age groups in terms of the percentage that are actually vaccinated. So this is really important as school gets started up again, and people travel back to Louisiana or from wherever they have been in order to start the fall semester. There've been more than 260,000 coronavirus cases linked to American colleges and universities since the first of this year and more than 700,000 cases over the course of the pandemic. And one of the things I heard from the governor's fellows this summer, and they're all government leaders, student government leaders I should say, on their campuses was that students and students in leadership were interested in doing their part to end this pandemic, stop this COVID surge by promoting vaccines and taking advantage of incentives and sharing trust and information with their peers so that everyone can feel confident about getting vaccinated so campus activities can get closer back to normal and can get back to normal as soon as possible. Gov. Edwards: (06:43) This shot at a... I'm sorry, Shot at 100 program will help our student leaders achieve that goal. With the spread of the highly transmissible Delta variant and its devastating impact on our communities, including younger populations, we are seeing more young people go sleeves up and that's good, but we have a very long way to go within that demographic. Students want an in-person college experience. They want as much normalcy as possible. To safely accomplish that, we need more shots in arms. It's in everyone's interest, however, not just in the interest of the young, it's in everyone's interest that this happens so that they protect themselves, their families and the community. I mean, that is the nature of a public health emergency. What every individual does, what every group does has implications, not just upon those individuals in groups, but on all of us. Gov. Edwards: (07:50) The fall semester is just a few days away for some institutions and maybe a couple of weeks for others. And we think this will make a difference in student vaccine uptake across the state of Louisiana. We are actively working with the Board of Regents and all of the higher education systems in Louisiana. And this includes the independent colleges and universities here in Louisiana as well. They are all eligible to participate and they're going to opt in if they choose to do this. And the program is going to be very easy for the colleges so that it may not look the same on every single campus and so forth. But we're going to try to make this as easy as possible for them. But this is basically how it's going to work, at participating colleges and university students will be given a deactivated visa card upon their vaccination, and then they will register online at shockfor100.com and that card will be loaded with $100. And to learn more about the exciting new program visit shotfor100.com or call our vaccine hotline at 1-855-453-0774. Gov. Edwards: (09:18) As you all know, being vaccinated is very important to stop this current surge, but also to reduce transmission and prepares for any surges that may come down the road. And as we slow transmission, you slow the rate of mutation and the variants that develop and so forth because there is nothing that prevents the next variant that happens from being even worse than Delta if you can imagine that. And so this is really important for all of those reasons and many, many more. These vaccines are safe, they're effective, they're free, they're convenient. And it doesn't matter where you live, in small towns, rural areas, in big cities, it's very important that you get vaccinated and that's true whether or not you happen to be in higher education. And please do it today if you haven't made that decision. This idea that I'm being safe, I'm going to do what I can do to protect myself from contracting the virus or being exposed to the virus and contracting the disease, it's just not enough, not when you have the Delta variant out there that is as transmissible as this one is. Gov. Edwards: (10:50) And by all accounts from the physicians that I'm talking to, they really believe it's more virulent as well. And people who continue to think, well, maybe I should be more concerned about the vaccines than about the virus, I want to share this little tidbit. And there's all sorts of data points out there that you can rely upon and that make a compelling case for the safety and efficacy of these vaccines and why being vaccinated is the smart choice for you and your family and your community. But for those people who have decided that they are more concerned about receiving the vaccine than actually contracting the disease. At this point, 2.1 million Louisianans have received least one shot. In fact, 3.8 million doses have been administered to those 2.1 million Louisianans. There have been exactly eight severe adverse reactions to the vaccine. By definition that means a hospitalization or death. None of the eight resulted in death, not one. But today, and I'm about to get to the numbers, we're going to report 57 deaths, that's just today, from COVID-19. Gov. Edwards: (12:39) So please think about that. And while we are on the numbers, today we're reporting 7,548 new cases of COVID-19. That's one of the highest daily numbers that we've reported at any point in the pandemic. 23% of our current cases are made up of individuals under 18 years old, 23%. Very sadly, as I just mentioned, we're reporting 57 new deaths. The total now is 11,519. We have 2,907 individuals in the hospital with COVID-19. That's the highest we've ever had in any given day. That's an increase of just six from yesterday, but it is an all time high thus far. 399 of those individuals are on mechanical ventilators and that is up 13 from yesterday. Our percent positivity is 16.1%. And you're going to see it chart in a minute. I think when Dr. Kanter comes up, this shows that we have the highest growth rate cases in the country right now. New cases, the seven day cumulative case rate, and it's not even close. It is not close. We're in a bad place and that's why we have to slow transmission and increase vaccinations. Gov. Edwards: (14:29) I want you to look at the number of hospitalizations. They're not just the highest that they've ever been, they're almost a third higher than at any other point in this pandemic. And look at the slope of the increase, that line is almost vertical. Our hospitals are struggling. Staff remains the limiting factor on capacity. Our staff at our hospitals, nurses, and doctors, and respiratory therapists and physician's assistants. I mean, you name it. They're maxed out and they've been doing this for 18 months. I was on a call earlier this week with all of our hospital medical leaders, our tier one hospitals from around the state. In fact, Dr. Logue was on that call. You're going to hear from her in just a moment. We've been having this call on a regular basis since the start of the pandemic. I will tell you that I've never heard them express more concern, more alarm, more anxiety than they did this week, because we are rapidly approaching the breaking point. Gov. Edwards: (15:48) And if you're an individual who's surgery has already been postponed to remove a tumor and you're a cancer patient, or if you had an organ transplant delayed because it was in a recovery room, if surgical repair of your aneurysm was delayed, and these things are happening. Then to you, we've reached the breaking point in our healthcare delivery. At this time, I'm going to ask Dr. Kanter to come up. He will be followed by Dr. Logue, and she would talk about what she's seeing at Lafayette General. She'll be followed by Dr. Thomas who's going to speak to the impact COVID is having on women who are pregnant and why they too, in accordance with the most recent CDC recommendation, should get vaccinated. And then as always, I'll come back up at the conclusion of those presentations for you. Joe. Dr. Joe Kanter: (17:15) Good afternoon. Thank you, governor. On behalf of Secretary Phillips and the Department of Health, we thank you again for your continued leadership throughout this pandemic. Sincere congratulations to Ms. Janet Mann for becoming Louisiana's newest millionaire, and we're proud of her. I want to sincerely thank doctors Logue and Thomas for coming here, and they'll share their accounts with you in a little bit. Both have been on the front lines and leading teams that are very much on the front lines throughout this pandemic. It's been incredibly challenging work. And if you need to be reminded about who some of the heroes are in this pandemic, two of them are right here without question. So I'm honored that you've joined us today. As the governor mentioned, there's really no good news that we can pick out from the data right now. We're really anxiously awaiting any sign that we have turned the corner of this unprecedented and very dangerous fourth surge. Dr. Joe Kanter: (18:14) And we've yet to see any concrete signs in the data. So it's been another week of historic increases in cases and hospitalizations. I'll walk you through the data that we're looking at momentarily. But suffice it to say yet again, we have never been to a point yet in this pandemic where there's this much COVID circulating, where there is these number of individuals requiring care in hospitals and where the situation in our acute care hospitals has never been as drastic as it is right now. That's was true last week when we spoke and it's more true now, fortunately, this week. In the top left, you'll see COVID like illness. This is the percent of ER visits that are attributable to COVID like symptoms like cough, fever, and shortness of breath. You do see a very, very tiny dip down at the end of that down to 14.4%, which is still a record looking back to the three prior surges. Dr. Joe Kanter: (19:19) It's difficult to know how to interpret that small dip. There is a line of thought that as hospitals get busy, and as we've asked people to try and avoid hospitals for minor symptoms, that they have done that for obvious reasons. And that might account for that very small dip. Regardless, it remains a historic number for us and reflective of the incredible burden that hospitals are facing right now. On the top right, you'll see incidents. This is the number of new cases of COVID diagnosed day on day, smoothed out over a seven day average. The number of new cases of COVID has gone up by 96% over the past two weeks. And over the past month, it has increased by 876%. It is higher now than it has ever been at any point in time during this pandemic, meaning there are more people diagnosed with COVID on any given day right now than there have been at any point in time during this pandemic. Dr. Joe Kanter: (20:19) Our two week incidence right now, that means the number of people being diagnosed over a two-week time period is at 1,389 per 100, 000 residents. That means that over the past two weeks, 1.4% of the entire population of Louisiana was infected with COVID-19. And that's just the infections that we know about, the ones that got diagnosed and reported to the Department of Health. On the average day right now, we are seeing 106 new cases per 100,000 residents. I mentioned that number because when we look at what the- Dr. Joe Kanter: (21:03) I mention that number because when we look at what the CDC considers to be high community transmission, the highest of the four categories they offer having over 100 cases per 100,000 residents per week puts you in the highest of CDCs for transmission and risk categories. And we are now exceeding that on a daily basis. We have high community transmission, the highest of the four possible categories in all nine regions of the state. So it is accurate to say that the risk has never been higher of contracting COVID no matter where you are in the State of Louisiana right now. In the bottom left-hand, you'll see on that purple line testing volume going up quite considerably, as one might expect as more COVID gets transmitted out there and more people get exposed. More people have reason to test either because they themselves are getting sick or they themselves were exposed to someone who is positive for COVID. Dr. Joe Kanter: (22:01) You also see the percent positivity on those orange bars on the bottom. Governor mentioned at 16.1% this week, we have not been that high since April 15th, 2020. When we were that high over a year ago in April 2020, we had seven times less testing volume being conducted in the state than we do now. That's back when it was very hard to get a test when it was being restricted through the CDC, there weren't a lot of tests out there and that artificially inflates the percent positivity. So in the context of seven times more tests being conducted across the state right now, a percent positivity of 16.1 is remarkable. Dr. Joe Kanter: (22:50) I'll tell you that over the past month, the number of people dying from COVID has increased 135% in all age groups. In individuals below the age of 40, it has increased 766%. That's a 766% increase in people who have died from COVID in the past a month below the age of 40. And on the bottom, right you'll see what was just shown a second ago in a zoomed in fashion, the number of patients who are hospitalized with COVID-19 at any one point in time in hospitals throughout the state. We are at the highest point now than we have ever been throughout the pandemic. As the governor noted almost a third higher, close to 1,000 people higher than at the prior max during our December and January surge. There are now 2,907 patients hospitalized in hospital beds right now, across the state with COVID-19. And the prior peak we had around the Christmas and New Year's time was just 2069. Dr. Joe Kanter: (23:55) We've surpassed that by a magnitude... We've added the past month, over 2,600 hospitalized COVID patients. We've added more patients over the past month than we had at our highest peak to date prior to this fourth surge, it really is simply remarkable and not sustainable. It already is not sustainable, as I think you'll hear from doctors, Logan and Thomas. Our epidemiologists have tracked 39 major new outbreaks over the past week attached to 251 associated cases. The largest settings tied to those outbreaks have been daycares, restaurants, work sites, and religious venues. If you take a look that new cases by age bracket, you'll see, number one, that we have tremendous increases across all ages right now, as we've had for the past few weeks. You'll also see yet again, individuals age 18 through 29, represent the largest share of new cases diagnosed day in and day out followed very shortly thereafter by individuals below the age of 18 and individuals between the ages of 30 and 39. Dr. Joe Kanter: (25:11) In today's data, of all the new cases reported to the department of health today, people below the age of 18 accounted for 23% of new cases, and that is substantial. And when we think about what will keep us safe going forward, and what will help us avert this surge going forward, we need to be reducing transmission wherever and whenever that transmission occurs. And it's very clear that transmission occurs regardless of age. We've had outbreaks in daycares, we've had outbreaks in summer camps when those were still in operation. And there's absolutely no question when you look at the data and when you dig into the contact tracing data that we see there is significant transmission amongst younger individuals including children. And that's why masking in those age groups are so very important because we will not be successful at averting this catastrophe if we do not reduce transmission wherever it occurs. The next slide, please. Dr. Joe Kanter: (26:15) Yet again, we unfortunately report that Louisiana leads the country in the number of new cases of COVID diagnosed every day. Florida is second place to us and not by a small amount either. We are yet again for another week, the number one COVID hot spot in the country. And if you zoom out and look at the national map right now, you can see if you got to go to the next slide please, that we continue to be an emanating hotspot with large amounts of COVID reaching out across our region. I want to take a step back now and talk about what does this mean for you? And clearly if your family member or you are sick with COVID, it means a great deal for you. But what if you're not? What does this mean for you? And I think you're going to hear some of this in Dr. Louis and Dr. Tom Thomas' remarks, but when our hospitals get this busy, they cannot provide the level of care and the quality of care for any patient that we have become accustomed to. And that's a serious thing to discuss and people need to be aware of that. Hospitals are stretched to the point that they are not able to provide the quality of care to any patient that they normally would under regular circumstances. We've had 58 hospitals to date reach out to the department of health, formally asking for help, indicating that they cannot meet their current demands with the current staff available to them and asking for help. That's unprecedented, never had anything like that before. I'll tell you personally, I continue to practice occasionally as an ER physician and I worked this past weekend and I wanted to share one example of how this reality of hospital resources being stretched in became so apparent to me. The hospital that I was practicing in still did have a couple of beds available at that point in time and was still receiving the occasional transfer from outside facilities. Not a lot of hospitals in the state are in that position. We accepted a transfer of a patient with what's called an ST Elevation, Myocardial Infarction, a STEMI or an acute heart attack, and the most severe type of acute heart attack. Dr. Joe Kanter: (28:51) We accepted a transfer of a patient with an acute heart attack who had to bypass six cath lab capable hospitals to get to us. A two hour ambulance ride to get to us for a condition that is amongst the most time sensitive conditions that we have in medicine. And we know every minute that we delay getting a patient with this type of acute heart attack up to the cath lab, every minute we delay that is literally heart muscle that dies, literally it's heart muscle of that patient won't have in the future should they recover from that condition and real functional impairment. And we track these types of patients in the number of minutes. We track how long does it take you to get this patient from the door of your emergency department, up to the cath lab and get the balloon of that catheter open? That's a measure we track and we track it down to the minute. Dr. Joe Kanter: (29:44) And this patient had to bypass six hospitals to get to us because none of those other cath lab capable hospitals had a bed available for this patient. These are the type scenarios that are happening all across the state right now. So if you think that this doesn't impact you because you or your family members are not currently sick with COVID, you're absolutely wrong because these types of medical emergencies happen to everyone and they happen when they are least expected. And to not have the resources of a normal quality hospital at your disposal is not something that we're accustomed to in this country and it's quite frankly scary. It was scary for this patient and it's scary for other families too. And I really think people need to understand that. And we also need to connect the dots. This is not happening by itself. The situation in the hospitals is not some type of event that we have no urgency in controlling. Dr. Joe Kanter: (30:46) We have all the urgency in the world to avert this situation. And it goes back to what we can do to reduce transmission. If people choose not to mask, if people choose not to distance, if people choose not to get vaccinated cases of COVID will go up, this surge will continue, and this situation in the hospitals will get worse. Meaning that Louisianans who need care for any reason will have a greater chance of not being able to receive that care when they need it. It comes back to our personal decisions right now of masking, distancing and getting ourselves vaccinated. Go to the next slide please. I think it's important to continue to be 100% transparent about what we see with breakthrough cases and the performance of our vaccines. And so we'll review these numbers. They're not substantively different from what we've seen in the past couple of weeks. Dr. Joe Kanter: (31:49) As of all cases being reported to the department of health last week, 90% were in individuals who are not fully vaccinated. Of all people hospitalized today, right now with COVID 19, 91% are individuals who are not fully vaccinated. And of all new COVID-19 deaths reported to the health department in the past week, 83% were in individuals who were not fully vaccinated. It remains as true as ever that these vaccines provide excellent, but not absolute protection. When it's pouring rain outside, you got to put on an umbrella and a rain jacket or else you're going to get wet. And so when we're in the middle of this type of surge, getting vaccinated is essential and you still need to take additional precautions beyond that, like distancing and wearing a mask because there was just so much, so much COVID out there. Dr. Joe Kanter: (32:50) We see that playing out in our nursing homes if you could go to the slide and I wanted to share this data, we haven't shared this slide in a little while, but I know Melinda, you asked some questions last week about nursing home cases. So I'll give you some stats and then I'll talk through what some takeaways of this data is. You'll see the blue line represents the number of new COVID-19 cases amongst nursing home residents. The red line represents a number of new COVID-19 deaths amongst nursing home residents. And the gray line represents the number of new COVID-19 cases amongst nursing home staff. This past week, we had 150 cases of COVID-19 amongst nursing home residents. That's up from 136 the week prior. We had 259 cases amongst nursing home staff, that's up from 246 the week prior. And we had five COVID-19 deaths amongst nursing home residents, that's down from eight the week prior. Dr. Joe Kanter: (33:53) Takeaway point number one on this is when you're in a high risk congregate setting and the governor's point that many times it doesn't get any more high risk than nursing homes. And you do not have 100% vaccination coverage. And right now, 52% of nursing home staff are at least initiated or completed the vaccine series and 87% of residents have initiated or completed. You're going to have some transmission. Oftentimes it comes from nursing home staff. And whenever time COVID is introduced in a high-risk congress setting like that, it will spread smally, particularly when we're in the middle of a giant surge. So that is why you see the blue line representing nursing home resident cases and the gray line representing nursing home staff cases go up Dr. Joe Kanter: (34:41) But the other takeaway of this is our vaccines are working and they're doing what they're supposed to do. And we do not see large increases in that orange line than the number of new deaths. And that's vitally important to note. These vaccines are designed to prevent hospitalization and death, and even in the highest risk setting that we have, where COVID-19 spreads very easily, and the individuals that it infects are of the highest risk nursing home residents, elderly nursing home residents, we still, despite moderate increases in cases have not seen a commensurate increase in deaths. And that's important, that's evidence that these vaccines are working. I cannot imagine what would be happening in nursing homes right now with this surge if we did not have 87% of residents initiated or completed the vaccine series. I also want to point out that there are now per federal guidelines by CMS when a nursing home has an outbreak or even one case that triggers a number of actions. Dr. Joe Kanter: (35:59) They typically do widespread testing so that they can mitigate through that and quarantine, isolate appropriately. They also may need to implement temporary visitation restrictions while they mitigate through that. And that's for good reason, that's to allow the nursing home to do what they need to do to get ahead of this outbreak so it doesn't spread more. I flagged that for families who might get frustrated because a nursing home that their loved one lives in might be under temporary visitation restriction. It's unfortunate, but it is for a good reason. It's difficult for nursing homes to mitigate through these cases, but they're doing a very, very good job of it. And we do apologize for failing that might have temporary restrictions because there's an outbreak that, that nursing home is working through. Ultimately it's for their loved one's safety, it's to keep their loved ones safe in that nursing home. Dr. Joe Kanter: (36:48) Next slide please. I guess one good news to report out on is our vaccination rate. And we continue to see good increases in our vaccinations. We've increased about 400% worth over the past month. A month ago, we were just over 2000 new vaccine administration initiations a day. And we went up to about 12,000 and it looks like we might be plateauing, maybe even coming down a little bit on that, but that's still is a substantial increase. As we've said two weeks on now, those are all individuals, the 11 or 12,000 people that chose to get vaccinated yesterday. Those are all individuals who changed their mind for one reason or another. And that's really encouraging and anyone can do that. So we are encouraged by this increase in vaccinations. I think it's unfortunate that it has to take a large surge to make this real for some people, but that is encouraging. And I think the more that we can continue this increase in vaccinations, the likely will help decrease the duration of the surge. It certainly will help protect us going forward against future similar surges. I think it's also important given the amount of COVID that's circulating right now to review what the symptoms of COVID are because there's classic symptoms like fever, cough, shortness of breath, but there's also more mild symptoms that I do worry some people might blow off and not take as serious as they should, particularly while we're in a surge like this. Minor symptoms like headache, loss of taste or smell, sore throat, congestion, or runny nose nausea or vomiting, diarrhea, or muscle or body aches can indicate COVID-19. They can indicate COVID-19, we see a lot of people right now, even with Delta that present with relatively mild symptoms, a runny nose, sore throat, sinus congestion, symptoms that can be easily disregarded as allergies or a little virus that picked up from their kid who's in daycare or something like that. It's important not to blow those off because they can easily be COVID-19 right now, just as easily as the more classic symptoms like fever, cough, and shortness of breath can. Dr. Joe Kanter: (39:08) Take away point being, if you have any of these symptoms, even mild symptoms, runny nose, sinus congestion, even mild symptoms, take them seriously, assume you're positive until proven otherwise, get tested, limit your contact with other people until you do so. And when you are out and about, remember there are three things you can do to increase your safety, regardless of whether you're vaccinated or not. You can be outdoors as opposed to indoors, you can distance yourself from others and you can wear a mask. And ideally you're doing at least two of those things. I'm going to pause there and I'll be happy to answer any questions if there are any. Melinda? Melinda: (40:01) In terms of the deaths that you're seeing among vaccinated people, can you talk about how many vaccinated people have died from COVID at this point and what the demographics look like of those deaths? Dr. Joe Kanter: (40:16) Yeah, we've had 100 deaths even right now in individuals who contracted COVID-19, despite being fully vaccinated. 23 of those were added in the past week. As the stats showed, over the past week, the average of all deaths were 83% of those were unvaccinated. That average has gone down a little bit as we've progressed through this Delta wave, because it's so virulent and because it's so widespread. If you look at people that have what we would consider to be severe, adverse, breakthrough infections, and by severe, I mean causing either death or hospitalization, the median age of those people is 74 years old. So it very much holds that when we do see severe breakthrough infections, that they tend to still be in the people that we know are at increased risk by virtue of age or underlying condition. Speaker 1: (41:26) Dr. Kanter earlier this week you said that if the recent surge doesn't peak within the next two weeks it would be a catastrophic situation for the hospitals. Could you explain what that means, a catastrophic situation? Dr. Joe Kanter: (41:43) Yeah. I will to the best I can. And the reason I say that is we've never been here before. So I know Dr. O'Neill addressed us the other day and I imagine Dr. Lug might too. This is not something that's happened before. We've never been to a place where not one hospital that... Dr. Joe Kanter: (42:03) Where not one hospital but almost every hospital in the state is at a point where they simply can't meet the demand that comes in. So I can't paint a great picture about what that looks like, because there's really nothing to go on. In speaking to hospital leaders like we do regularly, as the governor mentioned, what we have heard is that hospitals will do whatever it takes to provide care for the communities that depend on them. And I have no doubt about that. There is no question that that care is not the same type of care that somebody would receive during normal times, triage is a part of that. And hospitals are going to do the best that they can to save the most lives, do the most amount of good for the most people. But there's no question that if this trajectory continues for a couple more weeks, it will simply be catastrophic. It will be a level of need that hospitals are just not resourced to meet. And despite everything that we're doing to bring in additional resources, which is both contracted staff and federal assistance, we're not the only state in trouble and so it's very difficult to bring in those resources. Speaker 2: (43:20) We know you guys have made it clear the number one priority is to keep kids in schools, but with these outbreaks, at what point did the schools have to get to for the LDH decide, oh, students need to go virtual? Dr. Joe Kanter: (43:31) Typically it doesn't come down to that and looking at the experience of last school year. And I'll tell you for as challenging as last school year was, it was quite successful. I mean that in all sincerity, we were one of the earlier states in the country to bring kids back for in-person education. And we did a good job with contact tracing schools did a really good job with mitigation, with masking and distancing. And while we did have disruption, there were individuals who were exposed to COVID or contracted COVID outside of school, and obviously exposed people in the classroom and classes had to quarantine, students had to quarantine. There was disruption. What we did not see last year was a lot of transmission, and that's the most encouraging takeaway. Given the mitigating measures that were employed last year, despite the disruptions we did not see a lot of in classroom transmission. Dr. Joe Kanter: (44:26) Now there are some caveats that we did see some transmission in extracurriculars, sports, football, and so forth. But for actual classroom time there was not a lot of transmission. So that's the hope for this school year, is that through the mechanisms that we know are meaningful, we know are effective and this is now with 18 months of experience, particularly masking, in-person education can occur without an undue risk of transmission. Dr. Joe Kanter: (44:59) I think what happens sometimes, and I know you asked about closures and so forth, what we experienced last time is a school would have so many number of people who were exposed and then had to quarantine, and it might push their hand operationally. Say, well, if I have X percentage of my staff out tomorrow, maybe it makes sense not to open. We saw a lot of those, I can't recall an instance where a school closed on the order of direction of LDH. Speaker 2: (45:26) Is the LDH, are y'all tracking them? Because from what it seems like is unless there's transmissing multiple cases of COVID throughout a classroom or something, you guys are going to keep them open. Dr. Joe Kanter: (45:38) Again, it's not really LDH is decision in that. But we are tracking, we work closely with schools when there's an individual or student or a teacher who's positive. We work with that school to contact trace, and then we provide the recommendations of who needs to quarantine and for how long. Speaker 2: (45:55) That's what I needed. Thank you. Dr. Joe Kanter: (45:56) Yep. Yep. Thank you so much. I'm going to ask Dr. Amanda Logue, the Medical Director for Lafayette General Hospital to come up now. Thank you. Dr. Amanda Logue: (46:23) Good afternoon. Thank you Governor Edwards and Dr. [Kanter 00:46:27] for allowing us to be here and representing our situation. My name is Dr. Amanda Logue. I am the Chief Medical Officer for Ochsner Lafayette General. We are the largest healthcare provider in Acadiana, and we're a system of hospitals, five acute hospitals, in our region that is very comfortable taking care of our community of patients throughout the whole community. But this pandemic is completely stretching our resources. And I've been here before talking about this, but this is a worse than we've ever seen before. It's close to a breaking point and taking care of our community like we would like to, and like we're used to is becoming a very real challenge. Moreso now than in any other time that we've gone through this over the last 18 months. I never thought that we would actually be saying that given what we've gone through before, but here we are again. Dr. Amanda Logue: (47:24) One month ago we had 30 COVID-19 patients in our five acute care hospitals. This morning we have 162. At our main campus, which is our biggest campus in Acadiana, we have 98. The average age of those that are in the hospital is 54 years old. And consequently, the average age of the moralities that we've had during this surge is also 54 years old. That is 15 to 20 years younger than the moralities that we saw at any prior surge before. Which points into the direction of those that have the lowest vaccination rates and are therefore the most vulnerable patients and community members. That's just one virus that's taking up a full one-third of our hospital beds right now. It's consuming all of the energy that remains in our healthcare workers and this is the fourth time we've done this. So exhaustion is not really even the word that describes it all. Dr. Amanda Logue: (48:32) Last year our teams really feared what was coming next, what's the unknown, that was the scary part. But this year they're more anxious because they know what's coming, they've done it before. And they're on the edge of their seat kind of figuring out what are they going to be facing. And with these numbers going straight up practically, we don't really know what the limit is going to be. We don't know where we're going to end. We don't know where the peak is going to be. But they are remarkable and they come to the hospital and take care of their patients every day. And they come back to their shifts over and over and over again. Our entire community will never be able to thank them enough for this. And today, I personally think everyone that's doing this on the front lines. Dr. Amanda Logue: (49:17) I really want the community to understand, I think you've seen a good amount of this today, that it's affecting more than those who are just suffering from the virus. And that's why we all have to be concerned whether you have COVID or know somebody that has COVID or not. It's affecting those who aren't able to get a hospital bed for other reasons, and delaying surgeries. For several weeks in our facilities we've delayed surgeries of more than 100 every single week that goes by. You've heard us and others call them elective procedures, that doesn't mean just a minor procedure that's happening. These are procedures, as you heard, Dr. Kanter and Governor Edwards say that are slow growing tumors. These are aneurysms. These are bypass surgeries, heart bypass, and hysterectomies. And so they're not minor, they're certainly not minor to the person that's waiting on them and we don't consider them to be minor either, they're serious. Dr. Amanda Logue: (50:18) But the reason they have to be put off is because they are surgeries that need a bed to stay in afterwards. They might need several days of recovery in the hospital, sometimes even an ICU bed, to get the best outcome. And so we don't have a bed to give them for several days, which is why we have to put them off. It is not good care to do surgery without having the right level of care to take care of them afterwards. That postoperative part is just as important as the surgery itself. So they're suffering physically, we're watching them and keeping our eye on them to make that they are still doing okay. They know how to get in touch with us, but they're suffering, they're suffering emotionally and they have no idea when to expect that they could get back in and get their surgeries done. So we don't know how long we're going to have to do this. The longer it goes on, the more we worry about all of those patients that we're deferring, but we don't have an answer for them at this time. We just have to keep plugging on. Dr. Amanda Logue: (51:22) We are expanding our units everywhere that we can, we call that surging into different parts of the hospital. But in order to surge, we really have to have capacity and we have to have the people to do it. We are quickly running out of capacity, so our space is being filled up and we really have no more staff to pull from. I mentioned the 98 patients at one campus with COVID, that is just one hospital, in one city in Louisiana and the other major hospital in our city is experiencing the exact same scenario. Dr. Amanda Logue: (51:56) So the ripple effect is what should be resonating with our community members in our population. What happens is that those rural campuses have nowhere to send patients to the major hospitals and they don't have the type of resources to take care of some of these patients, like the acute heart attack that Dr. Kanter had talked about. So the patients sit in the emergency departments until they can find a room to go to. Then the ambulances roll up and there's no place in the emergency room to put them, so the ambulance EMTs are sitting with the patients in the hallways along the wall waiting for a bed to put them in. And then a patient out in the community calls 911, and there's not an ambulance to go to them. So that's the fear. That's the fear that we all have for any one of us that might get sick and try to pick up 911 and there's not enough people to come get you. It has not replaced heart attacks, strokes any of the major illnesses that continue to go on at this time. So COVID has added more volume onto the regular business that we do every day, which is very busy. Our emergency rooms are capacity, some of our wait times it's not uncommon for emergency rooms to have 7, 8, 9, 10 hours of waiting. And once they are triaged and get into a bed, if they do need to be admitted into the hospital, it's also not unusual for people to wait sometimes 48 hours, two days, in the emergency room waiting for a bed upstairs. So it is essentially gridlock in a lot of situations when we go through surges like this, and that is not the best way to care for a patient and it's not where we want them. Dr. Amanda Logue: (53:50) We are a level two trauma center and we're a tertiary care center, and what that means though, is that we received dozens of calls every day for patients to come to our hospital that need our services that they don't have at the other places. And we are happy to take them, we want them to come to us, but today we're not able to accept hardly any of those. We might get one bed open, and then we take a transfer in and that's it. And that might go on for 12 hours and then nothing, we can't take any more calls. Since this fourth surge has begun, we've declined nearly 70% of all the transfer requests from other hospitals. And these are smaller hospitals that need the help. And the calls are coming from everywhere, they're coming from all around the state and all around the surrounding states as well. And unfortunately we have to say, no. Dr. Amanda Logue: (54:43) That being said if you have an emergency situation, you feel like you're having a heart attack or stroke or something like that, we do need you to come seek care. We do not want anybody to sit at home because out of fear. You will be triaged. You will be stabilized. We'll do all of that stuff to the best of our abilities that we can, but we cannot promise that you'll be able to stay in Acadiana if you need to be admitted to the hospital, we might have to find a bed for you somewhere quite far away, whatever we can find. Dr. Amanda Logue: (55:14) So a lot of people say they don't really believe the case counts that those numbers are really growing at an alarming rates. But I can tell you, regardless of what you think about the case counts the hospitalizations are very, very real. And then the 90% of the people that are in our hospital right now that have COVID-19 are un-vaccinated. Dr. Amanda Logue: (55:38) So what can you do as a person in the community to help mitigate this? You've heard a lot about that up here. It's not too late to get vaccinated and to start building up your immune response. It doesn't matter where we are in a surge, it's still time. If you have one or two questions left that you need answered to make you feel comfortable with getting the vaccine, now is the time to do it. Get that answer, go to a trusted resource, go to a hospital website, have talked to your physician, get it answered so that you can go move on and get vaccinated and protect yourself and those that are around you. It's also time to hunker down, we need to avoid unnecessary gatherings and go back to being just around those that are the most protected around you. I think that most people went through this at some point during the last year, you kind of create your little safe pod around you. Those that you trust that you know are healthy, that are doing the right thing, that you can be around, that is where we have to get to right now. We have to be around those that we trust to tell us if they're feeling sick and we're not going to be hanging out until we are tested and until we feel better. Dr. Amanda Logue: (56:53) Certainly if you have any of the symptoms that are on the screen and that Dr. Kanter talked about, get tested earlier rather than later, just to make sure you don't have it. I have heard time and time again I felt like I had a sinus infection, so it's very confusing, I agree. It's very confusing to know do I have COVID, it's not as clear as it was before. But the testing is also widely available. So get it done early, that way you don't expose other people to your illness and that will help us slow the transmission down. Wearing your mask, when you are around anyone else, even if you're feeling well, will help protect both of you in case either one of you are infected with COVID-19 and you just don't know it yet. That's how a virus works, you infect others before you even realize that you are sick. That's how it continues to spread. That's why we put our masks on every day. Dr. Amanda Logue: (57:47) So it's really time for us to take some personal responsibility. It's time for us to understand that COVID is not just affecting patients with COVID-19. It is rippling out into all of the other areas of our life and it's affecting us all. So we need everybody to do their part. Thank you. And I'm happy to take questions. Speaker 3: (58:17) Hi doctor, thank you for being here. Can you help us understand how are you thinking about these next few weeks and what they might look like for your hospital if this surge doesn't turn a corner? Dr. Amanda Logue: (58:28) We have those conversations about what the next few weeks would look like every day. And we will have to likely make some really tough decisions. Some of our clinics are still open at this point they will have to be shut down to only the most urgent needs of our patients, which is not what we want. We want people to continue to receive their care from their doctors, but we will need all of those doctors and we will need all of their staff members to come to the bedside. We've already redeployed employees that are not taking care of people at the bedside to the bedside, and we have a little bit more we could do on that. Our surgeries would be 100% shut down, except for emergent only, and we would be able to redeploy a little bit there. After that, as you heard before, it's unchartered territory. We've never done it before, we never want to do it and we've thankfully never had to do it before. So we are thinking through all of the levers we could pull, but we're getting close to being there already. Speaker 3: (59:45) Just one other quick question. Shutting down clinics, can you talk about why that's a big deal? Dr. Amanda Logue: (59:51) Sure. To shut down clinics, we have patients that come in all day to see their doctor. Some for urgent needs, they're feeling sick that day, they need to be seen, and that's really important. But we also have ones that have lots of chronic diseases and going to see their doctor is what helps them stay well, they need some medication refills, they need to get a check on their diabetes, they need to have an exam done to see if everything is still going well. And so we would have to shut down the majority of that, where we would only be open for patients to come in that had something that was, they were sick that day. Everything else we could try to do some telemedicine with, and that is a more efficient method for us to do it, we're already doing some of that now but we may even have to shut down that because that does take a support staff, even just to run telemedicine it takes physicians. If we need them at the bedside, if our ICU overflows, if our regular beds overflow, we're going to need those doctors anyway. And so we would only have needs that were open for urgent purposes only. Dr. Amanda Logue: (01:01:07) I will turn it over to Dr. Thomas. Thank you. Dr. Thomas: (01:01:23) Dr. Logue and Dr. Kanter. Dr. Thomas: (01:01:25) So I am Dr. Terrie Thomas. I am a practicing OBGYN here in Baton Rouge, primarily at Woman's Hospital, we are a 350 bed hospital, and we are a specialty hospitals. So we, unlike the general hospitals, have been a little bit protected on our little island of woman's hospital from a lot of what you've heard from Dr. Kanter and Logue, but we also are suffering some of the effects of this pandemic. I was asked today here by the Governor to speak specifically about the new CDC guidelines, thankfully encouraging all pregnant and lactating women to get the vaccine. Dr. Thomas: (01:02:13) First of all, I'd like to start by reminding everyone of another seemingly hopeless time in our nation's history. We can all remember where we were and what we were doing when those two planes crashed into the twin towers. I was a medical student at Charity Hospital in New Orleans. And I watched in horror and disbelief as thousands of innocent people lost their lives that day. We are now facing another watershed moment in our country's history, only this time we actually have a weapon to fight it. We in the medical community have taken oaths to preserve and protect life. And so we are coming to you today, me and my colleagues- Dr. Thomas: (01:03:03) So we are coming to you today. Me and my colleagues, our neighbors, our family members, our friends, and we are pleading with you to please get vaccinated. This pandemic has not only taken lives, but has extraordinarily altered the course and quality of life for so many of us. This is not a political statement. I'm a physician I'm simply doing what I was trained to do. And that is to give good, sound medical advice. With that said, I'm so happy to have the support of the CDC and strongly recommending the COVID vaccine for pregnant and breastfeeding moms. They are in that high risk category of suffering serious or deadly consequences from COVID infection. Dr. Thomas: (01:03:55) I want everyone to focus on three very important research based facts. This is what we know. This is what we have solid proof of. Number one, it is completely safe for pregnant women to receive the vaccine at any point during pregnancy. Number two, the COVID vaccine does not cause miscarriages. Number three, moms that get the COVID vaccine while they are pregnant actually helped to pass protective immune chemicals to their unborn children that will then protect them after they are born. Dr. Thomas: (01:04:41) I trust that this research-based information settles the hearts and minds of all of you mama bears out there that are only looking to protect your children. I hope that I speak for all healthcare providers when I say that we did not go into medicine to watch our patients suffer and die. Your doctors and nurses in this city are tired. They're exhausted mentally and physically. Our children are mentally stressed from this pandemic. Please get the vaccine so that your doctors and nurses do not have to fight to save your life and your family members don't have to mourn your death. And you don't have to go out and protest for your kids not to have to wear a mask to school. Please get the vaccine so that we can all go forward with our lives, with some sense of normalcy, and reclaim the freedoms that we hold so dear. Thank you. I'll take questions. Dr. Thomas: (01:05:53) Excellent. I love it. No questions. Gov. Edwards: (01:06:03) Dr. Thomas and Dr. Lowe, Dr. Kanner, Thank you very much. I don't care who you are. When you go to the hospital, if you've got COVID and you've got a serious case, you're going to trust the physicians to do everything that they can in order to save your life. Put that trust in your physicians now, and let them give you the recommendation that is necessary to keep you out of the hospital in the first place. Put that same trust in them ahead of time. Gov. Edwards: (01:06:53) We've got to slow Delta down. We have to slow the transmission. We have to slow the hospitalizations. And Lord knows, we have to reduce the number of deaths that we're reporting every day. We do that by being vaccinated. We do that by wearing our masks and doing all the other common mitigation measures that have been discussed here today and really over the last 18 months. Gov. Edwards: (01:07:24) So let's do it. The time is now. No matter whether you have done this at any point prior, today is a new day, let's get with the program. Let's do what is required for ourselves, for our families, for our communities, for our state. Let's avoid the worst case scenarios that these doctors tried to tell you about that are not so far away in time, and that are already adversely impacting the quality of care and the amount of care that is being rendered across the State of Louisiana. All right, with that, I will take a few questions and I apologize. I know we've already been here for an hour and 10 minutes or so. Yes, sir. Speaker 4: (01:08:21) How you doing, governor? What is the vaccination rate in minorities around the state and what is the state doing to increase vaccination in minority communities? Gov. Edwards: (01:08:34) Today, all of the demographic groups in Louisiana are represented in their proportion to our populations as a whole. So in the information I received today, for example, 30.3% of all of the vaccinations that have been given have been given to African-Americans. African-Americans are about 32 to 33% of our state's population. If you take into consideration the other and the unknown categories, which are about 9%. And I'm certain that some part of that 9% are actually African-Americans, if you just add that to the 30%, you get to their percentage overall. And we're seeing that it is almost exactly the same for Hispanics, the number of shots being administer to Hispanics represent their proportion of the population as well. Gov. Edwards: (01:09:32) And we're seeing that obviously with white people too. So that information is fairly accurate. And I will tell you we do a better job here of capturing that information and making it available to people than just about any other state in the nation. And that is directly attributable to our early efforts with respect to the health equity task force, because we wanted to be able to dig in on these numbers and figure out what was happening and why, and take corrective action if necessary. And it just so happens that my memory is not that photographic, but we had the vaccine update just before we came over here today. So I feel very comfortable that I'm giving you accurate information. Yes, ma'am? Speaker 5: (01:10:21) Governor Edwards, I mean, you're an LSU fan. So of course I have to ask about Tiger Stadium and capacity. I mean, as of right now, they're preparing for a regular season at 100% capacity. What do you have to say about that? And are there any guidelines to come moving forward about that? Gov. Edwards: (01:10:34) Yeah. Well, the proclamation that I have in effect will be in effect until September the first. It's not going to change between now and then. I can't tell you what the next one will say, because we're not there yet. I know what the immediate task is. The immediate task is to slow transmission, to slow the growth in cases and hospitalizations and deaths. Right now, the CDC recommendations deal with masking indoors. But as you heard from Dr. Lowe, just a moment ago. And you heard from Dr. Kanner as well, outdoors is always safer than indoors and distancing is better than not distancing and wearing a mask. And so any two of the three typically work. And what I want to tell everyone. And really, I guess we have to do this on occasion. Gov. Edwards: (01:11:23) Just because some common sense mitigation measure is not being mandated doesn't mean that it ceases to be common sense. And so for anyone who wants to go to Tiger Stadium and watch a game, and you anticipate that you're going to be sitting within so many feet of your neighbors and so forth, you really ought to wear a mask, whether it's mandated for you or not. You ought to wear a mask. When you have the degree of community transmission that we have right now, that is the smart thing to do. But we're not there yet. And I'm not going to be more prescriptive than that right now. Yes, ma'am? Speaker 6: (01:12:10) Governor, there are some state workers who do jobs where it's hard to distance from like... I'm thinking correctional officers. I was wondering, I know you're not interested in vaccine mandate until FDA approval, but are you looking at either incentives, like you just saw for college students where you would offer some money to state workers or some gift card to get vaccinated or any sort of testing program for people who can't prove that they're vaccinated? Gov. Edwards: (01:12:41) Well, first of all, we encourage everyone to be vaccinated. If you have a job that requires you to be in close proximity to large numbers of others, you certainly need to be vaccinated. And if you're working in a congregant setting, you absolutely need to be vaccinated. We're a little over 50%. You've mentioned correction. We're a little over 50%? Is that high enough? No, and the secretary of law and others continue to stress the importance of that. I will tell you we're over 70% among the inmates. And it is clearly having a very positive effect on the number that are contracting the virus. And those who do, whether they require hospitalization and so forth. And you can clearly see much like the nursing home numbers you saw a while ago that is having a really positive impact. So we want more state workers, just like we want more of everyone to be vaccinated. Gov. Edwards: (01:13:39) With respect to incentives, I announced before you got here today an incentive for college students to be vaccinated. By the way, it's our hope that those $100 cards will be available at participating institutions of higher education as early as Monday, if they're having vaccination events. And we're going to work through the weekend to try to make that happen. And we may expand that beyond higher education. We're trying to focus on that now because of the data that we showed you that the 18 to 29 year old group is the one responsible for the greatest number of cases and the most transmission around the state. And we wanted to focus there. And then if that is successful and we figure out what we're doing, and we think it would be helpful more broadly speaking, that's something that we're certainly open to, that hey, that that should be sufficient to turn this tide and to get us to the peak and then start coming down on the backside of this surge. Gov. Edwards: (01:14:46) And I understand the question. We believe it's sufficient. It is what has been recommended to us as well. We just need people to do it. We need people to do it. And look, it hurts me to say this, but it's obvious that we did not take advantage of the time that we had before this surge in order to get more people vaccinated. It wasn't for lack of effort. It wasn't because the vaccine wasn't available and that we didn't have campaigns out there to communicate and so forth. But obviously for whatever reason we didn't do as well as we should have, and we would have liked. And I think we're now about fourth or so from the bottom of the list of 50 states in terms of the percentage of our people who have been vaccinated. Gov. Edwards: (01:15:39) I'm gratified to see that the demand for vaccines is up 400% or more from where it was a month ago, but we have a long way to go. We know that masks work. That's what allowed us to have safe in-person schooling last year. And every time we've had a mask mandate before, you could see about two weeks after that was implemented, that the numbers got better. And I'm very hopeful that that's going to happen this time. But the degree to which we were successful will be determined by the proportion of our people who follow these measures. Speaker 7: (01:16:19) Last question. Speaker 8: (01:16:20) Are there any plans to open a field hospital like earlier in the pandemic? Gov. Edwards: (01:16:24) I'm sorry. I couldn't figure out who was talking to me. The plans right now, first of all, we don't say no to anything as a contingency, but I think you heard Dr. Lowe and what I've heard all the other medical directors of our tier one hospitals say. Right now, the capacity is being constrained by staffing, not by beds. We have the ability to have many more patients, COVID patients and non COVID patients alike, taken care of in our existing hospitals. We just need the people. Gov. Edwards: (01:17:04) If we go outside of that and open a field hospital, we still can't staff it. And so our focus now is on making sure that we're staffing every bed that we can, especially ICU beds and surge beds within the tier one hospitals, which is why we have demat teams. These are disaster medical assistance teams from HHS at several hospitals. We have received ambulances. We received the EMTs and paramedics to help us with more monoclonal antibody infusion on the front end, hoping to keep people out of the hospital. We have the Department of Defense people come in, and I don't know that Dr. Lowe mentioned this. I can't remember, maybe she did, but we anticipate that there will be a team there at Lafayette General next week to assist. Gov. Edwards: (01:17:59) But really the options we have are just about all played out. That's going to be a relatively small team. I think we're expecting somewhere around 30 that's going to go to Lafayette General. I was at the Baton Rouge General Mid-City campus yesterday. There are about 98 or were yesterday, 98 COVID patients. Not a single empty ICU bed, but the only reason it was able to operate at all was 118 staff that the state brought in on a contract. Gov. Edwards: (01:18:31) Those kinds of opportunities are not out there anymore. No state has given up their healthcare workers because while the increase is worse here than anywhere else, there are increases all across the country. So the focus right now, the short answer to your question is, do we have contingencies to do that? Yes. Is it a meaningful, viable option when you don't have the staffing? No. And so, what we're going to focus on is surging within the existing footprint of our hospitals. And we're working every single day with every hospital, especially the tier one hospitals in our state to figure out where those opportunities are, how do we get more staff there? Dr. Lowe talked about closing some clinics and bringing those healthcare professionals in order to be bedside, as she mentioned it. Gov. Edwards: (01:19:23) That's what she's talking about. That's the most viable option for us, but everybody should be clear eyed about this. Our opportunities to increase our capacity are on the margins. They're not big numbers. And we are rapidly getting to the point where we could have a major failure of our healthcare delivery system. And there are some people out there whose care is being delayed to the point where for them, it's already failed. I mentioned that earlier. So we don't want it to get any worse. That's why we all have to come together. Gov. Edwards: (01:20:05) And again, today is a new day. It's a great day to be vaccinated. There's never been a better day than today if you're not vaccinated in order to go avail yourself of one of the safe, effective, free vaccines that are available in more than 1,400 locations. And we have to wear them a mask. We have to curb transmission. And for people who continue to question the necessity of that, or the wisdom of that, I just ask, what data are you looking at? From where are you getting your information? Do you not care what Dr. Kanner just shared with you and Dr. Lowe and Dr. Thomas? Let's pull together. Let's get through this. Again, I invite your prayers for our state and for all of our people, and especially for the healthcare professionals who have labored so long and so hard under such tremendously difficult circumstances. Thank you. And thank you again.